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. 2012:2012:371909.
doi: 10.1155/2012/371909. Epub 2012 Oct 31.

Cardiovascular disease in rheumatoid arthritis: a systematic literature review in latin america

Juan Camilo Sarmiento-Monroy  1 , Jenny Amaya-Amaya, Juan Sebastián Espinosa-Serna, Catalina Herrera-Díaz, Juan-Manuel Anaya, Adriana Rojas-Villarraga
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Cardiovascular disease in rheumatoid arthritis: a systematic literature review in latin america

Juan Camilo Sarmiento-Monroy et al. Arthritis. 2012.

Abstract

Background. Cardiovascular disease (CVD) is the major predictor of poor prognosis in rheumatoid arthritis (RA) patients. There is an increasing interest to identify "nontraditional" risk factors for this condition. Latin Americans (LA) are considered as a minority subpopulation and ethnically different due to admixture characteristics. To date, there are no systematic reviews of the literature published in LA and the Caribbean about CVD in RA patients. Methods. The systematic literature review was done by two blinded reviewers who independently assessed studies for eligibility. The search was completed through PubMed, LILACS, SciELO, and Virtual Health Library scientific databases. Results. The search retrieved 10,083 potential studies. A total of 16 articles concerning cardiovascular risk factors and measurement of any cardiovascular outcome in LA were included. The prevalence of CVD in LA patients with RA was 35.3%. Non-traditional risk factors associated to CVD in this population were HLA-DRB1 shared epitope alleles, rheumatoid factor, markers of chronic inflammation, long duration of RA, steroids, familial autoimmunity, and thrombogenic factors. Conclusions. There is limited data about CVD and RA in LA. We propose to evaluate cardiovascular risk factors comprehensively in the Latin RA patient and to generate specific public health policies in order to diminish morbi-mortality rates.

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Figures

Figure 1
Figure 1
Flow chart of the systematic literature review; VHL: virtual health library; RA: rheumatoid arthritis; JIA: juvenile idiopathic arthritis; CVD: cardiovascular disease.
Figure 2
Figure 2
Cardiovascular disease in rheumatoid arthritis in Latin America and the Caribbean; LA: Latin America; CA: Central America; SA: South America; C: Caribbean. aGeneral cause of death was evaluated. CVD was the highest. bSubclinical coronary artery disease. cHypertension and stroke. dNot CVD subphenotype measured. Prevalence regarding presence of atherosclerosis plaque. eHypertension fReferences [48, 49] report data from the same cohort of patients. Hence, the prevalence of CVD and risk factors is identical. gHypertension and atherosclerosis plaque. hHypertension and coronary artery disease. iHypertension and thrombosis. jVentricular diastolic dysfunction. kHypertension, stroke, and stable angina. lHypertension, stroke, coronary artery disease, peripheral vascular disease. mHypertension, myocardial infarction, angina pectoris, stroke, and peripheral vascular disease, and congestive heart failure.
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